ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Neurostimulation
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1654151
This article is part of the Research TopicElectroconvulsive therapy: from mechanisms to clinical practiceView all 11 articles
Efficacy and Influencing Factors of Modified Electroconvulsive Therapy for Schizophrenia: A Real-world Retrospective Observational Study
Provisionally accepted
- Nantong Fourth People's Hospital, Nantong, China
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Abstract Background Schizophrenia (SCZ) is a chronic and disabling psychiatric disorder. Modified Electroconvulsive Therapy (MECT), which involves electrical stimulation under general anaesthesia and muscle relaxation, is widely used to treat SCZ. Despite its rapid onset and robust therapeutic effect, the efficacy of MECT varies significantly between individuals. This study aimed to evaluate the clinical effectiveness of MECT in patients with SCZ and identify its influencing factors, with the goal of informing personalised treatment strategies. Methods This retrospective observational study included 237 inpatients with SCZ who received a full course of MECT at the Fourth People's Hospital of Nantong between January 2023 and December 2024. Treatment response was evaluated using the Positive and Negative Syndrome Scale (PANSS) reduction rate. Patients were classified into effective (≥50% reduction) and ineffective (<50% reduction) groups. Demographic, clinical, and treatment-related variables were compared between groups, and multivariate logistic regression was used to identify predictors of treatment response. Results The overall effectiveness rate of MECT was 70.46%. Multivariate analysis identified age ≥50 years (OR=0.111–0.078, P=0.010–0.002) and illness duration ≥10 years (OR=0.028–0.003, P < 0.05) as negative predictors of response. In contrast, first-episode SCZ (OR=6.537, P=0.003), higher baseline positive symptom scores (OR=1.325, P<0.001), and longer EEG seizure duration (OR=1.183, P<0.001) were positive predictors. No significant associations were found for sex, education level, or stimulus parameters such as current or frequency. Conclusion MECT remains a clinically valuable intervention for SCZ, particularly in younger, first-episode patients with prominent positive symptoms. Treatment efficacy is influenced by age, illness duration, baseline symptom severity, and seizure quality. These findings support the need for personalised MECT protocols guided by clinical and electrophysiological characteristics.
Keywords: Schizophrenia, SCZ, MECT, Electroconvulsive Therapy, EEG seizure duration, PANSS, treatment predictors, Personalised psychiatry
Received: 26 Jun 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Zhiping, Jiancheng, Zhang, Minmin and Xueting. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qiu Jiancheng, qjc_qq@163.com
Wang Xueting, xueting_wang2021@126.com
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